title: Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008.
abstract: OBJECTIVE
  To assess changes in the inequalities associated with maternal healthcare use according to economic status in the Philippines.
  
  
  METHODS
  An analysis of four population-based data sets that were conducted between 1993 and 2008.
  
  
  METHODS
  Philippines.
  
  
  METHODS
  Women aged 15-49 years who had a live-birth within 1 year in 1993 (n=1707), 1998 (n=1513), 2003 (n=1325) and 2008 (n=1209).
  
  
  RESULTS
  At least four visits of antenatal care, skilled birth attendance and delivery in a medical facility.
  
  
  RESULTS
  The adjusted OR for antenatal-care use when comparing the highest wealth-index quintile with the lowest quintile declined from 1993 to 2008: 3.43 (95% CI 2.22 to 5.28) to 2.87 (95% CI 1.31 to 6.29). On the other hand, the adjusted OR for the other two outcome indicators by the wealth index widened from 1993 to 2008: 9.92 (95% CI 5.98 to 16.43) to 15.53 (95% CI 6.90 to 34.94) for skilled birth attendance and 7.74 (95% CI 4.22 to 14.21) to 16.00 (95% CI 7.99 to 32.02) for delivery in a medical facility. The concentration indices for maternal health utilisation in 1993 and 2008 were 0.19 and 0.09 for antenatal care; 0.26 and 0.24 for skilled birth attendance and 0.41 and 0.35 for delivery in a medical facility.
  
  
  CONCLUSIONS
  Over a 16-year period, gradients in antenatal-care use decreased and the high level of inequalities in skilled birth attendance and delivery in a medical facility persisted. The results showed a disproportionate use of institutional care at birth among disadvantaged Filipino women.
authors.affiliation: International Health Section, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Honey Faith
authors.initials: HF
authors.lastname: Molina
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakamura
authors.forename: Masashi
authors.initials: M
authors.lastname: Kizuki
authors.forename: Kaoruko
authors.initials: K
authors.lastname: Seino
keywords: Public health; Reproductive medicine; Social medicine; Statistics & research methods